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Get Railway Concession Form Pdf

Application for Recruitment in Pay Band-1 of 5200- 20200 Grade Pay 1800 in South Central Railway Annexure-1 Railway Recruitment Cell / South Central Railway For Office use only Employment Notice Number RRC/SCR/Group D/1/2012 Control Number Roll Number Candidate must fill the application form with their own hand writing. Leaving any column blank will lead to rejection Name of Candidate in capital letters Father s name Date of Birth DD/MM/YYYY Community Tick Paste do not pin or staple here your recent colour passport size photo The photograph shall not be more than 3 months old. SC ST OBC UR a If OBC please state whether belonging to Minority Community Write Yes/No b If minority indicate community Are you Physically Disabled Tick Address for communication in capital letters VH HH OH Signature of the candidate Not in capital letters Nationality Religion Sex State Marital Status Pin Code 11. Nearest Railway Station In English only for issue of free Railway pass for SC/ST candidates 12. Visible Marks of Identification moles etc on your body 13. Do you seek age relaxation under any of the category mentioned below Tick appropriate box Physically Disabled Course completed Act Apprentice Judicially separated/ divorced woman/widow Ex-Servicemen Railway Employee 14. Educational Qualifications Qualification University/Board Year of Passing SSC/10th class ITI Others 15. List of Documents enclosed fill in the details of the copies of certificates/documents enclosed. i iii v ii iv vi 16. Details of IPO/Demand Draft enclosed with the application 17. Are you seeking fees exemption tick appropriate box Name of the post office/Bank Serial Number Date Amount Minority Female ExPerson with Economically Servicemen Disability Backward Class 18. Declaration by the candidate Please copy the following declaration in the space provided below in running hand writing NOT in capital letters I hereby declare that all the particulars given above by me are true and to the best of my knowledge. I am aware that in the event of any information furnished by me is found false / incorrect at any stage my candidature will be rejected summarily and I am also liable for criminal action* I will abide by the instructions given in the notification* Place Date Left hand Thumb Impression. Leaving any column blank will lead to rejection Name of Candidate in capital letters Father s name Date of Birth DD/MM/YYYY Community Tick Paste do not pin or staple here your recent colour passport size photo The photograph shall not be more than 3 months old. SC ST OBC UR a If OBC please state whether belonging to Minority Community Write Yes/No b If minority indicate community Are you Physically Disabled Tick Address for communication in capital letters VH HH OH Signature of the candidate Not in capital letters Nationality Religion Sex State Marital Status Pin Code 11. SC ST OBC UR a If OBC please state whether belonging to Minority Community Write Yes/No b If minority indicate community Are you Physically Disabled Tick Address for communication in capital letters VH HH OH Signature of the candidate Not in capital letters Nationality Religion Sex State Marital Status Pin Code 11. Nearest Railway Station In English only for issue of free Railway pass for SC/ST candidates 12. Visible Marks of Identification moles etc on your body 13.

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